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Summaries Of The News:

A House measure to address permanently the formula used to determine Medicare physician payments has taken shape, but its future is clouded by abortion issues and how it will be paid for. Meanwhile, GOP lawmakers are also attempting to advance budget resolutions in the House and Senate.

The Washington Post:
Republicans Heading For Whiplash On Partisan Budget, Bipartisan Health Bill
Congressional Republicans will have their governing bona fides tested again this week with key votes on the 2016 budget and a plan to revamp the payment system for doctors who treat Medicare patients. On the budget resolution, House Speaker John A. Boehner (R-Ohio) will be in familiar territory, trying to pass an austere spending plan with votes entirely from his side of the aisle but facing a revolt from the far-right flank, which insists on more ideological purity in budgeting (and nearly everything else). For the Medicare provision, Boehner worked preemptively with Democrats. The proposal, which has not provoked much division within his party’s ranks, could create some of the structural changes to entitlement programs that Republicans have long sought. (Kane, 3/23)

Politico:
Decision Time For Dems: Abortion Rights Or Helping The Poor?
A rare bipartisan health care bill taking shape in the House poses a real gut check for Senate Democrats as to what they care about most. Will it be pride of authorship and purity on issues like abortion rights? Or making the most of their reduced power in this Congress to solve problems and help those left behind in the economic recovery? (Rogers, 3/23)

The Associated Press:
AP Exclusive: GOP Hits Medicaid To Offset Doc Fee Hikes
House Republicans quietly deepened recommended budget savings from the government’s chief health care program for the poor by about $140 billion in recent weeks to offset part of the cost of higher payments to doctors who treat Medicare patients, according to officials familiar with the tradeoff. The maneuver comes as Republicans in both houses struggle with competing priorities, in this case a desire to stabilize what is widely viewed as a dysfunctional system of provider payments under Medicare, while pursuing a 10-year goal of balancing the budget. (Espo, 3/24)

The Associated Press:
House Dems Say New Abortion Language Helps Medicare Doc Deal
Language has been added to an emerging bipartisan deal on Medicare clarifying that the agreement’s abortion restrictions on community health centers are temporary and won’t be inscribed into permanent law, House Democrats said Monday. The Democrats said they believe the new provisions will ease concerns that have threatened Democratic support for the overall package, which is mostly aimed at protecting doctors who treat Medicare patients from imminent, deep cuts. (Fram, 3/23)

USA Today:
Budget Debate Highlights Divides In Congress
If Republicans can agree to a joint budget resolution, which sets spending levels for the upcoming fiscal year, they could also trigger a protected legislative process known as reconciliation. Republicans intend to use that process to repeal Obamacare, because it requires only a majority vote and cannot be filibustered. Even if they are successful, however, Obama would veto the measure if it reaches his desk. GOP leaders are hopeful that the appeal of targeting Obamacare will help ease ongoing intra-party divides over defense spending. (Davis, 3/23)

The Washington Post:
Federal Workers Could Pay More For Health Care, Get Less For Retirement Under GOP Plan
The federal budget proposed by House Republicans would reduce the amount of money that government employees earn on a popular retirement plan and potentially increase the amount they have to contribute to their health-care plan, according to newly released details. House Budget Committee Chairman Tom Price (R-Ga.) last week unveiled the spending blueprint — which aims to achieve several hundred billions of dollars in savings through measures affecting federal employees — but did not initially release the specifics. (Hicks, 3/24)

The nation's uninsured dropped by 11 million, according to the Centers for Disease Control and Prevention, while others note record slow growth in health care spending. But some experts raise questions about whether new models to pay doctors and hospitals will control costs.

The Associated Press:
CDC: Uninsured Drop By 11M Since Passage Of Obama's Law
The number of uninsured U.S. residents fell by more than 11 million since President Barack Obama signed the health care overhaul five years ago, according to a pair of reports Tuesday from the federal Centers for Disease Control and Prevention. Although that still would leave about 37 million people uninsured, it's the lowest level measured in more than 15 years. (3/24)

CNN Money:
5 Ways Obamacare Has Helped Americans
Much has changed since March 23, 2010. Nearly 11.7 million people have signed up on the Obamacare exchange for 2015 coverage. The growth in health care spending has slowed to record lows. Medicaid enrollment has soared to 70 million, up nearly 20% since mid-2013. (Luhby, 3/23)

Bloomberg:
How Obama's Plan To Control Health Care Costs Could Fail
The Affordable Care Act let the administration create several experiments designed to transform how health care is paid for. The goal is to find alternatives to the fee-for-service system that pays doctors and hospitals more for doing more tests and treatments. That system has long been blamed for hundreds of billions of dollars of wasteful spending that doesn’t help patients and sometimes harms them. In January, the Obama administration announced plans to accelerate a shift to new experimental payment models it has tested in the past few years. (Tozzi, 3/23)

Meanwhile, California and Colorado exchanges wrestle with problems -

Los Angeles Times:
Obamacare: California Sends 120,000 Corrected Tax Forms, Thousands More Coming
California's Obamacare exchange has sent out 120,000 corrected tax forms, but it said tens of thousands of other consumers are still waiting for their information. Peter Lee, executive director of the Covered California exchange, said those remaining households should get tax forms related to their health-law subsidies by the end of March. "We are very sorry for the inconvenience this has caused for too many consumers," Lee said. "This is far from ideal." (Terhune, 3/23)

The Denver Post:
Colorado Health Insurance Exchange Weak In Accounting, Auditors Report
An internal audit of Connect for Health Colorado found millions of dollars in mistakes, the latest in a string of audit reports showing poor financial controls at the state health insurance exchange last year. The audit, presented to the exchange board Monday, found questionable costs of as much as $12 million — most described as "material weaknesses" in internal controls. (Draper, 3/23)

The analysis by the Kaiser Family Foundation also projects that 45 percent of households getting subsidies would receive refunds from the government after reconciling the tax credits with their 2014 income.

The New York Times:
Many Will Need To Repay Health Subsidies
Half of the households that received subsidies to help pay health insurance premiums last year under the Affordable Care Act will probably have to repay some of that money to the federal government, according to a new analysis by the Kaiser Family Foundation. The foundation also predicted that 45 percent of households that received subsidies will probably get a refund, because their 2014 income was lower than what they estimated when they applied for coverage. (Goodnough, 3/24)

Politico Pro:
Analysis: Half Will Have To Repay Health Tax Credit
Half of the people who received subsidies under the Affordable Care Act in 2014 will owe money to the government because they underestimated their incomes when applying for coverage and got too large a monthly premium credit, according to a new analysis from the Kaiser Family Foundation. (Villacorta, 3/24)

Kaiser Health News:
Tax-Time Tribulations: Health Law Complicates Filing Season For Many
This tax season, for the first time since the health law passed five years ago, consumers are facing its financial consequences. Whether they owe a penalty for not having health insurance or have to reconcile how much they got in premium tax credits against their incomes, many people have to contend with new tax forms and calculations. Experts say the worst may be yet to come. (Andrews, 3/24)

Meanwhile, a report underscores the role of premium subsidies and a Republican lawmaker eyes contingency plans if the Supreme Court strikes down federal exchange subsidies.

The Hill:
GAO: ObamaCare Subsidies Crucial For Expanding Coverage
The government's watchdog agency on Monday underscored the role of ObamaCare tax credits at a time when the Supreme Court could make them illegal in a majority of states. ... The tax credits reduced healthcare costs for millions of people, which “likely contributed to an expansion of health insurance coverage” in 2014, according to the nonpartisan study. The new research bolsters support for the Obama administration’s long-time assertion that tax credits are a central part of the healthcare law's success. (Ferris, 3/23)

Modern Healthcare:
Republicans Eye Budget Maneuver To Pass GOP Subsidies Fix
House Ways and Means Chair Paul Ryan says Republicans need to have a plan in place by June 20 to respond if the U.S. Supreme Court strikes down subsidies in up to 37 states. A ruling in the King v. Burwell case, which challenges the legitimacy of insurance subsidies in states that haven't established their own exchanges, is expected near the end of June. (Demko, 3/23)

Hospitals in the U.S. benefited from a $7.4 billion reduction in uncompensated care costs last year, according to a government report. Hospitals in the 28 states, plus D.C., that expanded Medicaid under Obamacare saw $5 billion of that savings, while the cost of unpaid bills declined by $2.4 million in states that did not expand.

USA Today:
Medicaid Expansion Slashes Hospitals' Unpaid Bills
Hospitals in states that expanded Medicaid to their poorest residents faced about $5 billion less in unpaid bills last year — about twice the reduction as those that did not expand this health care coverage, according to a new federal report. The Department of Health and Human Services released the report at a Virginia event marking the fifth anniversary of the Affordable Care Act. The ACA expanded Medicaid, but a Supreme Court decision gave states the option of offering Medicaid to all of their citizens or not, and 22 states have not done so. (O'Donnell, 3/23)

Modern Healthcare:
Affordable Care Act Credited $7.4B Drop In Uncompensated Care
Hospitals' uncompensated-care costs in Medicaid expansion states were reduced by $5 billion in 2014, according to an HHS report published Monday, the fifth anniversary of the Affordable Care Act. The costs of uncompensated care declined $2.4 billion in states that did not expand the program, resulting in a total drop of $7.4 billion, down 21% from 2013. (Dickson, 3/23)

Medicaid-expansion states also saw a 23 percent rise in newly diagnosed cases of diabetes, according to a new study -

NPR:
States That Expand Medicaid Detect More Cases Of Diabetes
Fonseca and his colleagues wondered whether Medicaid expansion under the Affordable Care Act, which became law five years ago Monday, has improved the detection of diabetes. That possibility seemed likely because more poor people now have insurance. In 2012, the Supreme Court ruled that states could choose whether to expand their Medicaid programs under the ACA. In January 2014, about half the states, including Ohio, expanded and about half did not. This created what Fonseca calls a natural experiment — an opportunity to compare the impact of Medicaid programs on diabetes care. (Kelto, 3/23)

The Fiscal Times:
Diabetes Detection Up In Pro-Obamacare States
The number of newly-diagnosed cases of diabetes has surged by 23 percent in states that accepted the expansion of Medicaid eligibility that was made available under the Affordable Care Act, compared to an increase of less than one percent in some states that declined the expansion. (Garver, 3/23)

Helena (Mont.) Independent Record:
Medicaid Expansion Bill Stalls In Committee As Opponents Add Amendments
The sole surviving bill to expand Medicaid coverage to as many as 70,000 low-income Montanans took another strange twist Monday night, as it stalled in committee after opponents attached several unfriendly amendments. Yet the sponsor of Senate Bill 405, Sen. Ed Buttrey, R-Great Falls, said after a series of votes in the Senate Public Health Committee that he didn’t consider the action all bad, and that his bill remains alive. (Dennison, 3/23)

The Kansas Health Institute News Service:
Passions High On Both Sides Of Medicaid Expansion Debate
The recent legislative hearings on Medicaid expansion brought representatives from dozens of powerful groups to the Statehouse. Lobbyists representing hospitals, doctors and some big businesses pleaded with members of the House Health and Human Services Committee to approve an expansion proposal one day. The next, representatives of conservative, anti-tax organizations urged committee members to continue to say ‘no’ to expansion, despite the billions of additional federal dollars it would inject into the Kansas economy. (McLean, 3/23)

The Associated Press:
NC Advocates Plan Day To Call For NC To Expand Medicaid
Dozens of advocates are expected in Raleigh to deliver a petition to Gov. Pat McCrory asking him to back expanding Medicaid in North Carolina. The advocates are calling Tuesday Medicaid Expansion Advocacy Day. They timed the event for the day a proposal to expand the government health insurance is expected on the floor of the North Carolina House. (3/24)

The Associated Press:
Bid To Revive Tennessee Medicaid Expansion Moving In Senate
An effort to revive Republican Gov. Bill Haslam's Insure Tennessee proposal received a positive recommendation in a Senate subcommittee Monday. The resolution sponsored by Democratic Sen. Jeff Yarbro of Nashville would authorize Haslam to pursue his plan to extend health coverage to 280,000 low-income Tennesseans. The governor's original proposal was defeated in a Senate committee in a special session in February. ... The measure now moves to the Senate Health Committee, which has a different makeup than the specially appointed panel that rejected the Insure Tennessee proposal on a 7-4 vote last month. Four senators on the nine-member committee have now voted in favor of the measure either in the special session or in the subcommittee. Supporters will need to find at least one more vote to get the bill to advance out of the full committee. (3/24)

The Republican senator, who announced his presidential campaign on the fifth anniversary of the health law, made his vow to eliminate it a key part of his remarks at Liberty University.

The Wall Street Journal:
In 2016 Bid, Cruz Lays Out Conservative Agenda
Sen. Ted Cruz on Monday began his campaign for the White House with a call to abolish the 2010 health law and the Internal Revenue Service, an appeal for greater school choice and a proposition to his party: that Republicans can win the White House only if they nominate a forceful conservative like himself. The Texan, who became the first major candidate of either party to enter the 2016 race, laid out an argument here that Republicans have failed in presidential elections because their nominees were insufficiently conservative, leaving evangelical Christians and others on the political right to sit out the vote and hand victory to the Democrats. (Epstein and Ballhaus, 3/23)

Fox News:
Sen. Ted Cruz Announces Presidential Bid, Vows To 'Stand For Liberty'
Cruz spoke on the fifth anniversary of Obama's health care law -- legislation that prompted Cruz to stand for more than 21 hours in the Senate to denounce it in a marathon speech that delighted his Tea Party constituency and other foes of the law. Cheers rose in the hall when Cruz reminded the crowd Monday that Liberty University filed a suit against the law right after its enactment. (3/23)

The Associated Press:
Humana To Narrow Focus Outside Insurance With Concentra Sale
Humana plans to sell occupational health care provider Concentra for about $1.06 billion, as the health insurer refines its focus on providing patient care. The Louisville, Kentucky, company said Monday it will sell Concentra to a joint venture between specialty hospital operator Select Medical Holdings Corp. and the private equity fund Welsh, Carson, Anderson & Stowe XII LP. Humana will then use proceeds from the deal to buy back stock. (3/23)

In other Humana news -

Modern Healthcare:
DaVita Pulled Into Federal Humana Investigation
DaVita HealthCare Partners has been drawn into a federal investigation of Humana's Medicare Advantage risk-adjustment practices, DaVita said in a Securities and Exchange Commission filing Monday. The subpoena relates to an ongoing investigation into the risk-adjustment practices of Humana and its service providers, including how patient diagnoses were determined, according to the filing. (Schencker, 3/23)

Tenet Healthcare Corp. announced a joint venture with United Surgical Partners International Inc. that will enable it to fully own the company within five years.

The Wall Street Journal:
Tenet Healthcare, United Surgical In Short-Stay Surgery Deal
Tenet Healthcare Corp. agreed to a deal that will hand it control of United Surgical Partners International Inc. as consolidation picks up among hospital companies seeking to adapt to pressure from the new U.S. health-care regime. Tenet said it would create a joint venture with Welsh Carson Anderson & Stowe, combining Tenet’s short-stay, or ambulatory, surgery centers and imaging facilities with USPI, which the private-equity firm owns. Tenet will initially own 50.1% of the operation, with the right to buy the rest over five years. (Cimilluca and Weaver, 3/23)

Reuters:
Tenet In Deal To Create Largest Outpatient Surgery Provider
Tenet Healthcare Corp on Monday said it would become the largest U.S. provider of outpatient surgery services through a joint venture with United Surgical Partners International and expects to fully own the company within five years. More medical procedures are being performed on an outpatient basis as technology improves, thus lowering costs by allowing patients to go home sooner. (Kelly and Grover, 3/23)

The Dallas Morning News:
Health Care Tie-Ups For Tenet, Baylor, Concentra
Several big Dallas-based health care firms announced a blur of partnerships and acquisitions Monday. The tie-ups aren’t final until regulators have had their say. If approved, however, the first deal announced Monday would make Tenet Healthcare Corp. the nation’s largest operator of outpatient surgical centers. (Landers, 3/23)

Also in marketplace news, a tentative deal with the Justice Department -

The Wall Street Journal:
Lab Reaches Tentative Deal With Government Over Doctor Payments
A laboratory that has collected large sums from Medicare has reached a tentative agreement with the Justice Department to pay nearly $50 million to settle a civil investigation into whether payments it made to doctors amounted to kickbacks, according to people familiar with the matter. The tentative accord involving Health Diagnostic Laboratory Inc. follows a Page One article in The Wall Street Journal in September that detailed the company’s practice of paying doctors to send it patients’ blood for testing. (Carreyrou, 3/23)

The so-called "40-mile" rule often makes it difficult for those living outside large cities to prove they live far enough away from a VA health center to get private medical care instead. The VA will now rely on driving distance to determine the distance, not a straight line.

The Associated Press:
VA Says It Will Relax 40-mile Rule For Private Medical Care
Responding to pressure from Congress and veterans groups, the Department of Veterans Affairs is relaxing a rule that makes it hard for some veterans in rural areas to prove they live at least 40 miles from a VA health site. The change comes amid complaints from lawmakers and advocates who say the VA's current policy has prevented thousands of veterans from taking advantage of a new law intended to allow veterans in remote areas to gain access to federally paid medical care from local doctors. (Daly, 3/24)

The Military Times:
VA Choice Program's Distance Rule To Be Revised
After much debate over how the Veterans Affairs Department chose to define the 40-mile distance rule for veterans to access the new Veterans Choice health program, VA will announce today that it's changing the definition. Rather than use an "as the crow flies" measure of 40 miles, VA will rely on driving distance from a VA medical facility as the qualifier to use Veterans Choice, a program that lets veterans see a civilian health care provider if they live in a remote area or can't get an appointment at a VA facility. Under the VA Access, Choice and Accountability Act passed by Congress last year, veterans who live more than 40 miles from a VA facility were supposed to have access to the Choice Card program. (Kime, 3/24)

The Associated Press:
As Patients Face Death, Doctors Push Straight Talk On Care
Dr. Angelo Volandes remembers performing rib-cracking CPR on a frail elderly man dying of lung cancer, a vivid example of an end-of-life dilemma: Because his patient never said if he wanted aggressive care as his body shut down, the hospital had to try. He died days later. Years later, the Harvard Medical School researcher now tries to spur conversations about what care patients want during life's final chapter through videos that illustrate different options. (Neergaard, 3/23)

The Wall Street Journal:
Alzheimer’s Patients Aren’t Always Told They Have Alzheimer’s
More than half of people with Alzheimer’s disease, or their caregivers, have never been told by their doctors that they have the condition, according to a new study from the Alzheimer’s Association, a nonprofit advocacy group. “We are alarmed. This means that people are being robbed of the opportunity to make important decisions about their lives,” says Beth Kallmyer, the association’s vice president of constituent services. (Beck, 3/23)

Elsewhere, Ohio mistakenly sends letters to 4,200 providers telling them they were being dropped from the state's Medicaid program, and Arkansas readies to notify thousands that they may soon lose their Medicaid coverage.

Concord Monitor:
Members Of House Finance Committee Reverse Course On Medicaid Cuts
After voting last week to eliminate coverage for “optional” Medicaid services – not mandated by the federal government but still critical for many residents living with injury or disabilities – state representatives reversed course yesterday afternoon, opting to maintain funding after all. ... Citing a need to achieve a balanced budget with less revenue than what the governor was predicting, representatives last week proposed cuts to a number of Health and Human Services programs. Along the way, representatives voted to cut coverage for 20 categories of optional Medicaid services for adults over age 21 – including wheelchair van services, private duty nursing, inpatient and outpatient mental health, adult medical day care and audiology services, like hearing aids. In the days since, New Hampshire residents who use these services expressed serious concern that this decision would create serious financial burdens and jeopardize their ability to maintain a basic quality of life. (McDermott, 3/23)

New Hampshire Union Leader:
House Budget Writers Begin Finalizing Their Plan
House budget writers voted along party lines to reduce Gov. Maggie Hassan’s proposed budget Monday and will continue working Tuesday to ready the spending plan for a vote next week. ... Democrats expressed concern about a $15 million reduction for the new Medicaid Management Information System, which has been delayed and gone over budget. The system processes medical claims from the Medicaid health insurance program for the poor, disabled and elderly and pays providers for their services. Rep. Marjorie Smith, D-Durham, noted the investment in the new electronic billing system was being reduced after years of “inordinate delays” and at a time when it provides a possible benefit to the state. (Rayno, 3/23)

Columbus Dispatch:
Ohio Medicaid Letter Drops 4,200 Providers In Error
The Ohio Department of Medicaid said it erred last week when it sent letters to about 4,200 doctors, home-care workers and other Medicaid providers notifying them that they were being kicked out of the Medicaid program. A coding mistake made on Wednesday during a routine system update led to the improper notifications, said Ohio Medicaid spokesman Sam Rossi. (Price and Sutherly, 3/24)

The Associated Press:
Arizona House Passes Bill On Abortion Restrictions
The Arizona House on Monday approved a bill barring women from buying any health care plan through the federal marketplace that includes abortion coverage after stripping out a provision that would have made the names and addresses of abortion providers public. The proposal passed on a 33-24 party-line vote after heated debate that lasted more than an hour, with all but one Republican who voted backing the proposal. (Christie, 3/23)

The Kansas Health Institute News Service:
Kansas Senate Passes Mental Health Drug Compromise
Legislators of all political stripes came together Monday as the Senate passed a compromise bill regarding regulation of mental health drugs dispensed under Medicaid. Mental health advocates had balked at the Kansas Department of Health and Environment's earlier bid to repeal a law barring the state from imposing any restrictions on psychotropic medications under Medicaid. A bill to do so failed to clear the Senate in February. (Marso, 3/23)

The Associated Press:
New Plan To Control Mental Health Drugs Advances In Texas
A new proposal for controlling mental-health drug costs in the Medicaid program in Kansas advanced in the Legislature on Monday, weeks after the Republican-controlled Senate rejected another plan from GOP Gov. Sam Brownback's administration. The Senate gave first-round approval to a bill requiring a review of Medicaid's mental health prescriptions. The measure also creates an advisory committee to draft guidelines on prescriptions for 368,000 needy and disabled residents whose health care is covered by the $3 billion-a-year program. (Hanna, 3/23)

The Boston Globe:
As Nursing Homes Close, Residents Scramble To Find Alternatives
Hundreds of frail nursing home residents have been forced to move as a growing number of Massachusetts facilities have been bought, sold, and closed over the past two years, state records show. But the public has had virtually no say in the process. A Massachusetts law passed last summer was designed to provide public comment about the closing or sale of nursing homes, yet state officials have not put that into effect. Regulators say they are still working on rules to implement the law. (Lazar, 3/24)

Los Angeles Times:
On Obamacare's 5th Anniversary, Americans Are Starting To Feel Appreciation
Coverage of the Affordable Care Act's fifth anniversary Monday -- it was signed into law March 23, 2010--will undoubtedly focus on the gains in coverage and reductions in healthcare costs that have followed its rollout. To get the raw figures out of the way first, 16.4 million previously uninsured people now have insurance, the uncompensated care expenses of hospitals have fallen by more than 20%, and the rate of medical inflation is at a historic low. But a less-noticed trend also may be unfolding: Americans are beginning to appreciate that Obamacare has improved the nation's healthcare system, and their lives. (Michael Hiltzik, 3/23)

Bloomberg:
Obamacare's Happy And Healthy 5th Birthday
The law is working more or less as it was supposed to. The two goals of the Affordable Care Act were to expand coverage and to cut costs. The first part has worked as the drafters expected. Even though the effort has fallen short in states that have refused Medicaid expansion (which U.S. Supreme Court allowed them to do), the law has sharply increased the number of Americans with health insurance. The picture is murkier when it comes to costs. Health-care inflation has slowed considerably. It's just hard to know to what extent, if at all, Obamacare is responsible. (Jonathan Bernstein, 3/23)

McClatchy:
Feds Will Continue To Build On Obamacare Successes
[F]ive years ago this week, ... millions of Americans ... found hope in a new law, the Affordable Care Act. After years of dropped coverage, flimsy plans and barriers to care, everyone’s coverage has improved, because consumers have new protections, including those who get health insurance through their employers. They can’t be turned away because of pre-existing conditions; they can’t be dropped just because they get sick and insurance has to cover care that Americans count on, like trips to the emergency room, prescriptions and preventive services. And coverage is now affordable for millions of Americans. (HHS Secretary Sylvia M. Burwell, 3/23)

The Washington Post:
Rubio’s Repeal And Replace
Every GOP candidate for president will run on repealing Obamacare. They will joust for the distinction of being the competitor who most dislikes the law. But for now, Sen. Marco Rubio (R-Fla.) is the only top 2016 contender to offer a concrete alternative. ... In his book American Dreams, Rubio makes clear he favors an eventual phase-out of the exclusion for employer-provided health-care plans while transitioning everyone to a tax credit system. ... The effort to shift from third-party payers to a system in which health-care users are encouraged to shop for value is an essential part of controlling health-care costs, one that remains largely absent in the Obamacare system. (Jennifer Rubin, 3/23)

The New York Times:
Imagine President Ted Cruz
Of course, if you know [Sen. Ted] Cruz, or are familiar with how government is supposed to work, or with reality in general, you’ll find some of his imaginaries problematic, like abolishing the Internal Revenue Service, sealing the border, or “repealing every word of Obamacare.” “Imagine a federal government that works to defend the sanctity of human life and to uphold the sacrament of marriage,” he said. But Mr. Cruz says he is a champion of personal liberty, too, and gay people who love each other are demanding their liberty to marry, just not in a way he finds acceptable. No data support Mr. Cruz’s claim that insurance premiums are “skyrocketing” under Obamacare. (3/23)

USA Today:
GOP Budgets Substitute Illusion For Substance: Our View
Both GOP budgets rely heavily on huge and politically unlikely spending cuts and bewildering gimmicks that don't begin to add up. Both proposals are more partisan wish lists than serious attempts to attack one of the nation's most serious problems. For example, both budgets would get $2 trillion of their more than $5 trillion in presumed savings over the next decade by repealing Obamacare. President Obama would veto that even if Congress managed to pass it. And killing the law before Republicans agree on what to do when millions of people lose their insurance policies is nonsensical. (3/23)

USA Today:
Sen. Enzi: Washington Must Live Within Its Means
Last week, Congress began the monumental task of confronting our nation's chronic overspending and exploding debt, which threaten each and every American. Make no mistake, our fiscal outlook is grim and has been ignored for far too long. But we have a profound moral responsibility to help taxpayers see the true picture of our country's finances. (Sen. Mike Enzi, R-Wyo., 3/23)

The New York Times' The Upshot:
Why Congress Is Having Trouble Governing
The [budget-setting] process is already exposing cleavages within the Republican caucus, between those who want to increase military spending and those who want to reduce deficits. If they succeed in arriving at a budget, it will strengthen their hand against President Obama’s health care law, environmental agenda and more, setting up standoffs in which the president wields his veto pen; if they don’t, it may well start to feel like 2013 all over again, with new showdowns over the debt ceiling or a potential government shutdown. (Neil Irwin, 3/23)

The Wall Street Journal:
Government Love ...
The Obama Administration often claims to be a careful steward of taxpayer dollars, and today’s punch-line is the collective $124.7 billion program called “improper payments.” That’s the Washington circumlocution for money that flows to someone who is not eligible, or to the right beneficiary in the wrong amount, or vanishes to fraud or federal accounting incompetence. ... The other two big culprits are traditional Medicare and Medicaid fee-for-service reimbursements. Compared to the earned-income credit, these are roaring successes with respective error rates of 12.7% and 11.6%. Then again, for a program as large as Medicare the error rate translates into $45.8 billion of annual waste, fraud or abuse. (3/23)

The Wall Street Journal's Washington Wire:
Will ‘Doc Fix’ Include A Compromise On Children’s Health Insurance?
Democrats on the Senate Finance Committee issued a news release Saturday expressing concern about provisions for children’s health insurance in the Medicare “doc fix” bill taking shape in the House. Media coverage of the children’s health program has largely focused on the length of the extension: Senate Democrats want a four-year extension, while a summary of the House agreement released Friday has a two-year reauthorization. But there are other, fundamental policy disagreements. (Chris Jacobs, 3/23)

USA Today:
Millennials Will Change Abortion Conversation
The conventional wisdom is that young people are strongly pro-choice. While it is not surprising that Baby Boomers and Gen Xers eventually grew more skeptical over time, when they were teenagers and young-adults, they too were all-in for abortion rights. But the demographic future of the United States is defying that conventional wisdom. (Charles C. Camosy, 3/23)

The Washington Post:
Raise The Smoking Age To 21
Forty-two million Americans still smoke. That is a much smaller proportion of the population than decades ago. But it’s still a public health disaster: Eighteen percent of adults put themselves and their families at risk of major and wholly preventable health problems. Education programs, changing social attitudes and higher tobacco taxes have pushed the smoking rate down, and cigarette bans have made the air a lot less foul in public places. But a new report articulates the logic behind an additional approach to fighting tobacco: Raise the age at which people can legally buy tobacco products to 19, 21 or even 25. Cities, states and even Congress should consider this option seriously. (3/23)